The present invention relates to ensuring compliance of healthcare staff with handwashing protocols and more particularly to using wireless devices for ensuring compliance with the handwashing protocols.
Society incurs a great cost due to nosocomial (hospital-acquired) infections, both in human suffering and in healthcare expenditures. It is estimated that each year two million people acquire infections while visiting or being cared for in the hospital. About 5% of these infected, i.e., nearly one hundred thousand people, die from those infections. Pennsylvania hospitals, for example, billed the Medicare and Medicaid systems $1.4 billion dollars in 2004 for treatment of nosocomial infections in approximately nine thousand patients. This averages to a cost of about $154,000 per infection. Patients are becoming increasingly aware of the scope of the problem, producing a mounting threat of hospital liability lawsuits based upon nosocomial infections.
Long ago nosocomial infections were identified as a major problem, with healthcare workers' hands determined to be the main means of infection and disease transmission. Accordingly, protocols were devised instructing healthcare workers to clean their hands with warm water and soap, or with an antiseptic handrub, before and after every patient contact. However, despite relentless educational and motivational efforts, no major study has shown compliance with these protocols to be greater than 50%. In other words, on average, healthcare workers only wash their hands about half the recommended number of washings.
An anonymous survey of healthcare workers, described in “Infect Control Hosp Epidemiol” 2000; 21:381-386, Pittet D., listed the following reasons for non-compliance with handwashing protocols or why healthcare workers often fail to do something so simple and with well-documented benefits:                Handwashing agents cause skin irritation and dryness;        Sinks are inconveniently located;        Lack of soap and paper towels;        Too busy/insufficient time;        Understaffing/overcrowding;        Patient needs take priority; and        Low risk of acquiring infection from patients.        
The issue can be examined, using Duke University Healthcare Systems (DUHS) as an example. DUHS employs about 5,000 nurses. If each nurse works three shifts a week, at twelve hours per shift, with ten patient contacts per hour, then the handwashing requirement for the DUHS nursing corps is 90,000,000 handwashings annually. Currently, enforcement of handwashing protocols is essentially nonexistent, as awareness of infractions is essentially nonexistent.
A situation thus exists in which many healthcare workers are failing to wash their hands as directed, even though they are well aware of the requirement to do so. When the healthcare workers are not intrinsically motivated to perform the required action, they must then be extrinsically motivated. Extrinsic motivation falls into two general categories: reward and punishment. The decision of punishing or rewarding an action, however, depends on the awareness of that action by the individual healthcare workers.